ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 R47.01

Billable / Specific CC

Aphasia

R47
Block
0
Synonyms
579
LCDs
32
Payer Policies
4
Linked CPTs

About ICD-10-CM R47.01

ICD-10-CM code R47.01 represents Aphasia. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R47). The 2026 edition of ICD-10-CM R47.01 became effective on October 1, 2025.

Coding Tips for R47.01

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

R47.01 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Type 1 Excludes

Pure excludes, these codes can never be coded together with R47.01. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • aphasia following cerebrovascular disease (I69. with final characters -20)
  • progressive isolated aphasia (G31.01)

Inpatient DRG Impact, CC

codes Aphasia. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for R47.01

Local Coverage Determinations (LCDs) from CMS MACs that list R47.01 as a covered diagnosis.

579 LCDs

Showing top 10 of 579 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92524 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 96112 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92521 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97130 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97129 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92597 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97110 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97533 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 96110 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92522 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing R47.01.

32 policies

1 Cigna

Duplex Scan of Extracranial Arteries - (0542)
Policy ID: MM_0542

5 Medicare

Billing and Coding: Speech-Language Pathology
Policy ID: ART-52866
Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies
Policy ID: ART-52992
Billing and Coding: Home Health Speech-Language Pathology
Policy ID: ART-53052
Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Policy ID: ART-54111
Billing and Coding: CT of the Head
Policy ID: ART-56612

CPT Codes Commonly Billed with R47.01

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

4 linkages
  • 70553 MRI brain with and without contrast — migraine, headache, encephalopathy, brain cancer, epilepsy, brain neoplasm, cognitive decline, MS, hydrocephalus, aphasia, numbness Radiology
  • 95819 EEG awake and asleep — epilepsy, generalized seizures, absence seizures, focal seizures, seizure NOS, fasciculations, syncope, encephalopathy, cognitive decline, aphasia, migraine, headache, insomnia Neurology
  • 70473 CMS LCD: Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP) CMS LCD
  • 70472 CMS LCD: Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP) CMS LCD

Convert R47.01 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
R47.01 7843 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 R47.01, Billing FAQ

Is ICD-10 code R47.01 billable? +

Yes, R47.01 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for R47.01? +

Type 1 Excludes (never code together with R47.01): aphasia following cerebrovascular disease (I69. with final characters -20); progressive isolated aphasia (G31.01)

Is R47.01 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with R47.01? +

Procedures frequently paired with R47.01 include: 70553, 95819, 70473, 70472.

What ICD-9 codes does R47.01 map to? +

Per CMS GEMs, R47.01 maps to ICD-9 codes: 7843. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 2, 2026.

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